Public Health and Social Controls: Implications for Human Rights

Abstract

This paper which is part of a larger project on social control and human rights commissioned by the International Council on Human Rights Policy explores the difficult and complex relationship between public health, human rights, and the social controls that states use to protect their population’s health, especially from infectious diseases. The paper highlights the importance of recognizing that public health interventions operate as social controls and shares the insights that social control theory can offer to public health and human rights advocates. The paper begins by reviewing the right to public health protection and discusses contemporary understandings in international law and public health ethics of the relationship between the right to health and other human rights in the face of serious epidemics. The paper then explores the role that social factors play in constructing how societies perceive epidemics and respond to them. Particular emphasis is given to contemporary fears of emerging epidemics and the development of public health preparedness. The paper then looks closely at several different types of public health interventions that operate as social controls and may infringe upon the rights of individuals, particularly in marginalized communities, including surveillance, mandatory testing, travel controls, isolation and quarantine, mandatory vaccination, and criminalization. Examples are given relating to many different infectious diseases, including HIV/AIDS, tuberculosis, SARS, and influenza, from many nations around the world. The paper demonstrates why the social construction of emerging infections undermines the ability of the existing international human rights framework to ensure that public health protection does not result in the unnecessary infringement of human rights or discrimination against vulnerable populations. The paper concludes by offering guidelines for human rights activists and public health officials hoping to protect both public health and human rights.